| NPI | 1417302399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN FOSSUM COO 214-295-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-10-12 |